General practitioner conduct of clinical services representing comprehensive geriatric assessment is associated with lower risk of mortality in older Australians receiving home care packages.

Abstract

The purpose of this paper is to investigate the utilisation of general practice Medicare Benefit Schedule (MBS) services aligned to Comprehensive Geriatric Assessment (CGA) within 6months of an aged care eligibility assessment and its effects on mortality and transition to permanent residential aged care (PRAC). Retrospective cohort study from the Historical Cohort of the Registry of Senior Australians. Community. In total, 69,171 Individuals (aged 75+) receiving home care packages (HCPs) between 2011 and 2015. Mortality and transition to PRAC. The claims for a management plan with team care arrangement (TCA) within 3months of the health assessment (i.e. CGA) was present in 5% and associated with 14% lower mortality (adjusted hazard ratio [aHR], 95%CI = 0.86, 0.80-0.93) compared to no claims, lower than that seen with partial CGA which was either health assessment claims only 7.0% (aHR, 95%CI = 0.93, 0.89-0.97) or management plan coupled with TCA claims only 9.0% (aHR, 95%CI = 0.91, 0.89-0.97). This pattern was seen in those frailer but not in those where the frailty index score was <0.21. Claims for management plans coupled with TCAs alone were associated with a 10% lower transition to PRAC (asHR, 95%CI = 0.90, 0.85-0.96) in those with FI score < 0.21 while this estimate was not significant in individuals with FI score≥ 0.21. It appears the conduct of a combination of interventions considered to be components of the CGA by GPs was associated with a lower risk of mortality that no claims or partial conduct of CGA.